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• W1974767508 abstract "We provide information that we believe should allow the establishment of rational guidelines for discontinuing, with physician supervision, unsuccessful prehospital CPR. Goldberg 35. Goldberg AH Cardiopulmonary arrest. N Engl J Med. 1974; 290: 381-385 Crossref PubMed Scopus (53) Google Scholar has advocated that CPR be terminated only after evidence of brain or cardiac death has persisted for more than one hour of adequately applied advanced CPR. This recommendation was made for inhospital resuscitation and does not reflect the limited capabilities of basic and advanced CPR techniques to sustain life outside the hospital. In addition, White and associates 36. White BC Winegar CP Henderson O et al. Prolonged hypoperfusion in the cerebral cortex following cardiac arrest and resuscitation in dogs. Ann Emerg Med. 1983; 12: 414-417 Abstract Full Text PDF PubMed Scopus (24) Google Scholar have demonstrated that after resuscitation from prolonged cardiac arrest, cerebral cortical blood flow is reduced severely. This state of hypoperfusion may last up to 18 hours. Because this condition can result in extensive neurologic damage, it may explain the poor survival rates after prolonged resuscitation. We propose that CPR be terminated in the ED when, despite adequate rescue attempts (intubation, defibrillation, IV medications, CCCM en route) by those responding at the scene of cardiac arrest, intrinsic cardiac activity has not been achieved in patients brought to the hospital with asystole or bradyarrhythmia. Additionally patients who have had advanced prehospital CPR for more than 45 minutes without generation of any intrinsic cardiac activity are not resuscitatable by current standard techniques, and CPR may be discontinued. These criteria must not be used for victims of hypothermia before a core temperature of 35 C to 36.1 C is achieved by active core rewarming during CPR. The available data suggest that if these criteria are implemented, many unproductive hospital-based resuscitative efforts can be eliminated without jeopardizing potential survivors. In patients brought to the hospital with VF or VT vigorous resuscitation is indicated, particularly if the patient has received only prehospital CCCM without the benefit of defibrillation. Patients with witnessed cardiac arrest who have had immediate CPR but not definitive prehospital care may benefit from ED CPR even if they have a bradyarrhythmia. Continued efforts at resuscitation are potentially lifesaving in these patients." @default.
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• W1974767508 date "1985-11-01" @default.
• W1974767508 modified "2023-09-29" @default.
• W1974767508 title "Guidelines for discontinuing prehospital CPR in the emergency department — A review" @default.
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• W1974767508 doi "https://doi.org/10.1016/s0196-0644(85)80928-8" @default.
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